Safety and utility of Endoscopic Ultrasound with Bronchoscope-guided Fine Needle Aspiration (EUS-B-FNA) in suspected lung cancer patients with poor respiratory or general conditions: a prospective three-center observational study.
Driver oncogene
Endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA)
Lung cancer
Next-generation sequencing (NGS)
Programmed death ligand 1 (PD-L1)
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
14 Jun 2023
14 Jun 2023
Historique:
received:
08
01
2023
accepted:
01
06
2023
medline:
16
6
2023
pubmed:
15
6
2023
entrez:
14
6
2023
Statut:
epublish
Résumé
Although transbronchial diagnostic procedures are sometimes difficult to perform because of the patient's respiratory or general conditions, endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA), a known transesophageal diagnostic procedure, might be useful for such cases. We conducted this prospective three-center observational study to evaluate the safety and efficacy of EUS-B-FNA in suspected lung cancer patients with poor respiratory or general conditions. Patients with suspected lung cancer with respiratory failure, Eastern Cooperative Oncology Group performance status of 2 or higher, or severe respiratory symptoms, were enrolled. The primary endpoints were the diagnostic yield of lung cancer and its safety, and the secondary endpoints were the success rate of molecular and programmed death ligand 1 (PD-L1) analyses, and the 6-month survival rate in patients with lung cancer. We enrolled 30 patients, of which 29 were included in the analysis. Among them, 26 were eventually diagnosed with lung cancer. The diagnostic yield for lung cancer was 100% (26/26). There were no adverse events associated with EUS-B-FNA requiring procedure discontinuation. The success rates of molecular analysis for EGFR, ALK, ROS-1, and BRAF were 100% (14/14), 100% (11/11), 100% (9/9), and 75% (6/8), respectively. The success rate of the PD-L1 analysis was 100% (15/15). The 6-month survival rate in patients with lung cancer was 53.8% (95% confidence interval [CI]: 33.4-76.4), and the median overall survival (OS) was 196 days (95% CI: 142-446). EUS-B-FNA is a safe and effective diagnostic method, even in patients with suspected lung cancer with poor respiratory or general conditions. This clinical trial was registered at https://www.umin.ac.jp/ctr/index.htm (UMIN000041235, approved on 28/07/2020).
Sections du résumé
BACKGROUND
BACKGROUND
Although transbronchial diagnostic procedures are sometimes difficult to perform because of the patient's respiratory or general conditions, endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA), a known transesophageal diagnostic procedure, might be useful for such cases. We conducted this prospective three-center observational study to evaluate the safety and efficacy of EUS-B-FNA in suspected lung cancer patients with poor respiratory or general conditions.
METHODS
METHODS
Patients with suspected lung cancer with respiratory failure, Eastern Cooperative Oncology Group performance status of 2 or higher, or severe respiratory symptoms, were enrolled. The primary endpoints were the diagnostic yield of lung cancer and its safety, and the secondary endpoints were the success rate of molecular and programmed death ligand 1 (PD-L1) analyses, and the 6-month survival rate in patients with lung cancer.
RESULTS
RESULTS
We enrolled 30 patients, of which 29 were included in the analysis. Among them, 26 were eventually diagnosed with lung cancer. The diagnostic yield for lung cancer was 100% (26/26). There were no adverse events associated with EUS-B-FNA requiring procedure discontinuation. The success rates of molecular analysis for EGFR, ALK, ROS-1, and BRAF were 100% (14/14), 100% (11/11), 100% (9/9), and 75% (6/8), respectively. The success rate of the PD-L1 analysis was 100% (15/15). The 6-month survival rate in patients with lung cancer was 53.8% (95% confidence interval [CI]: 33.4-76.4), and the median overall survival (OS) was 196 days (95% CI: 142-446).
CONCLUSIONS
CONCLUSIONS
EUS-B-FNA is a safe and effective diagnostic method, even in patients with suspected lung cancer with poor respiratory or general conditions.
TRIAL REGISTRATION
BACKGROUND
This clinical trial was registered at https://www.umin.ac.jp/ctr/index.htm (UMIN000041235, approved on 28/07/2020).
Identifiants
pubmed: 37316839
doi: 10.1186/s12890-023-02508-2
pii: 10.1186/s12890-023-02508-2
pmc: PMC10265839
doi:
Substances chimiques
B7-H1 Antigen
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
206Informations de copyright
© 2023. The Author(s).
Références
Eur Respir J. 2015 Apr;45(4):1098-107
pubmed: 25323241
Surg Today. 2020 Sep;50(9):1049-1055
pubmed: 32166496
Clin Lung Cancer. 2017 Sep;18(5):527-534.e1
pubmed: 28111119
Medicina (Kaunas). 2021 Nov 19;57(11):
pubmed: 34833490
Lung Cancer. 2019 Oct;136:1-5
pubmed: 31421256
Eur J Cancer. 2009 May;45(8):1389-96
pubmed: 19124238
J Bronchology Interv Pulmonol. 2013 Apr;20(2):121-6
pubmed: 23609245
Cancer Sci. 2020 Oct;111(10):3739-3746
pubmed: 32726470
Thorax. 2009 Sep;64(9):757-62
pubmed: 19454408
Chest. 2008 Aug;134(2):368-374
pubmed: 18263688
J Thorac Oncol. 2017 Jul;12(7):1161-1166
pubmed: 28238961
Pulmonology. 2022 Jan-Feb;28(1):28-33
pubmed: 32507497
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
Endoscopy. 2015 Jun;47(6):c1
pubmed: 26062074
Respiration. 2014;87(4):343-51
pubmed: 24434575
Intern Med. 2021 Apr 1;60(7):1061-1065
pubmed: 33132332
J Clin Oncol. 2009 Mar 20;27(9):1394-400
pubmed: 19224850
Lung Cancer. 2014 Mar;83(3):396-400
pubmed: 24457105
Respir Care. 2015 Jul;60(7):1040-50
pubmed: 25759463
Chest. 2013 May;143(5 Suppl):e211S-e250S
pubmed: 23649440
Dig Endosc. 2018 Jul;30(4):433-440
pubmed: 29733468
Chest. 2015 May;147(5):1259-1266
pubmed: 25275701
Br J Cancer. 2012 Oct 9;107(8):1220-6
pubmed: 22996611